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Assessing ACEI and ARB utilization in Karachi's diabetic nephropathy patients
Faisal Aslam1, Syed Muhammad Aqeel Abidi2, Syeda Tayyaba Fatima Abidi3
1The Indus Hospital, Indus Health Network, Korangi Crossing, Karachi, Pakistan.
Pakistan Journal of Pharmaceutical Sciences
|January 17, 2026
Summary
Diabetic nephropathy patients in Karachi show low use of ACE inhibitors (ACEIs) and ARBs, despite proven benefits for kidney health. Improving physician awareness and patient education is crucial for better renal outcomes.
Area of Science:
- Nephrology
- Endocrinology
- Public Health
Background:
- Diabetes mellitus (DM) is a global health issue, with diabetic nephropathy a leading cause of chronic kidney disease.
- Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are established treatments to slow diabetic nephropathy progression.
- Utilization patterns of ACEIs and ARBs in Karachi, Pakistan, for diabetic nephropathy are understudied.
Purpose of the Study:
- To determine the prevalence of ACEI and ARB use in Karachi patients with diabetic nephropathy.
- To identify demographic and clinical factors associated with ACEI/ARB utilization.
Main Methods:
- A cross-sectional study at Aga Khan University Hospital, Karachi (Sept 2021-Aug 2022).
- 118 patients with diabetic nephropathy were analyzed for demographics, ACEI/ARB use, creatinine, ischemic heart disease history, and physician type.
- Statistical analysis included chi-square tests (p < 0.05 significance).
Main Results:
- Only 26.3% of patients received ACEIs or ARBs; 9.3% were under endocrinologist care.
- Females (30.9%) and older patients (>65 years, 41.9%) showed higher utilization rates.
- Coronary artery disease was present in 66.9% of the cohort.
Conclusions:
- Significant underuse of ACEIs and ARBs in Karachi's diabetic nephropathy patients was observed.
- A gap exists between clinical guidelines and real-world prescribing, indicating a need for improved physician awareness and patient education.
- Addressing these gaps can enhance renal outcomes and reduce the burden of diabetic kidney disease in South Asia.
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